For Transplant Surgeon, It’s All About the Cure
One in an ongoing series
For Nikolaos Chandolias, MD, transplant surgery is as close to magic as you get in medicine. When you transplant a kidney, liver or pancreas into a sick patient, he said, if all goes well, they’re cured.
“If a patient complies with our regimens, they should have their life back within two months,” said Dr. Chandolias, a transplant surgeon at Einstein Healthcare Network.
“In many other treatments, there’s no full restoration to health, but there is with transplant surgery,” he said, citing, for instance, a patient with Type 1 diabetes who receives a new pancreas after being insulin dependent since childhood. “There’s nothing better than the smile you get when you tell someone ‘You’re not a diabetic anymore.’ This isn’t maintenance; it’s a cure.”
That’s why it’s worth it to Dr. Chandolias to be on call 24 hours a day, seven days a week. That’s why it’s worth it to sacrifice hobbies or activities that might inhibit his ability to be immediately accessible. That’s why it’s worth it to work around the clock when the hospital is notified that an organ is available.
Dr. Chandolias and Einstein’s four other transplant surgeons perform approximately 65 liver transplants and 70 kidney transplants a year.
It all starts with a phone call from the Gift of Life Donor Program, the regional organization that allocates organs, notifying Einstein that an organ is available and an Einstein patient is eligible. There’s a national list that ranks patients based on how dire their illness is and how long they’ve been waiting.
Sometimes, Dr. Chandolias is the surgeon who stays at Einstein and prepares the potential recipient for surgery. Sometimes, though, he’s part of the team that travels to retrieve the organs from the donor, driving hours to get there, removing the organs, driving hours back – and then, occasionally, being the one who also puts in the new organ.
There can be as many as six surgeons from different hospitals gathered around the donor’s body to take out the heart, lungs, liver, kidneys and pancreas.
Dr. Chandolias said he doesn’t meet the donor’s family, and he doesn’t focus on the sorrow of the patient’s death. “The organ is a gift made at a time of sadness, and we make something good out of something bad. We take the gift and find someone to receive it.”
A resident or physician’s assistant accompanies the surgeon on the mission, and they return with the organ in a sterile container literally labeled: Organ. They go right to the operating room, where the patient has been prepped.
It can be a 24-hour day, after which “I only want to go home and sleep,” Dr. Chandolias said.
But transplant surgery is subject to the same irksome circumstances that impact other pursuits: for some reason, they occur in clusters. There will be days of quiet, when no organ is available, then days of frenetic activity when two or three are available at the same time, leading to successive days of little sleep in between trips and operating rooms.
“It takes a toll, but we get rewarded by a good outcome,” he said.
Dr. Chandolias said the work is gratifying beyond the benefit to individual patients. He said it’s rewarding to be part of Einstein’s mission to provide medical care to an underserved population. And he noted that the illnesses that often lead to transplant – high blood pressure, diabetes, alcoholism – may reflect a social inequity that leaves patients without access to medical care, education or motivation born of hope.
“These are diseases of society; it goes beyond the individual,” Dr. Chandolias said.
If only there was a magical cure for that. Until then, transplant surgery is as close as it gets.
Learn more about the Einstein organ transplantation program.